Chest X-Ray Lateral Cross-Table (Trauma)

Chest Trauma projection — horizontal beam VAR
Objective

Lateral visualisation of the chest in a supine non-mobilisable patient. Detection of pneumothorax, haemothorax and pleural effusion by fluid layering with a horizontal beam. Complementary to the AP bedside view.

Quality criteria

Pleural space visible along the full height of the thorax.
Diaphragm included inferiorly.
Trachea and carina identifiable.
Retrosternal and retrocardiac spaces distinguishable.
Air/fluid layering visible if present.

Common errors

Cassette not vertical — negates fluid layering.
Beam not perfectly horizontal — level artefact.
Arm not raised — obscures the lung field.
Overexposure — loses interstitial detail.

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Positioning, centring, DR/CR parameters and practical notes

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